Redispensing of medicines unused by patients: a qualitative study among stakeholders
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Abstract
Background Medication waste has undesirable economic and environmental consequences. This waste is partly unavoidable, but might be reduced by redispensing medicines unused by patients. However, there is little knowledge of stakeholders’ views on the redispensing. Objective To identify the stakeholders’ views on the redispensing of medicines unused by patients. Setting Dutch healthcare system. Method Semi-structured interviews were conducted with 19 Dutch stakeholders from September 2014 until April 2015. The interview guide included two themes: medication waste and redispensing of unused medicines. The latter included qualitative-, legal- and financial aspects and stakeholder involvement, with specific attention to the patient. Interview transcripts were subjected to thematic content analysis. Main outcome measure Requirements related to the redispensing of unused medicines. Results All stakeholders considered the redispensing of medicines desirable if the implementation is feasible and the requirements for the safe redispensing are met. All of them pointed out that the product quality of redispensed medicines should be guaranteed and that it should be clear who is responsible for the quality of redispensed medicines. The stakeholders stated that transparent communication to patients is essential to guarantee trust in the redispensing system and that patients should be willing to use redispensed medicines. Moreover, the redispensing system’s benefits should outweigh the costs and a minimal economic value of medicines suitable for redispensing should be determined. Conclusion Redispensing unused medicines could decrease medication waste if several requirements are met. For successful implementation of a redispensing system, all relevant stakeholders should be involved and cooperate as a joint-force.
Keywords
Medication waste Qualitative research Redispensing Stakeholders The Netherlands Unused medicinesNotes
Acknowledgements
We are thankful to all stakeholders that were willing to participate in our study.
Funding
CB was partly funded by Pfizer with an unrestricted grant. Pfizer did not contribute in any way to the study design, data collection, analysis and manuscript.
Conflicts of interest
C. Bekker reports grants from Pfizer, while conducting the study. Dr. Gardarsdottir reports grants from Innovative Medicine Initiative Joint Undertaking (www.imi.europa.eu), outside the submitted work. All other authors declare they have no conflict of interests.
Supplementary material
References
- 1.IMS Institute for Health Informatics. Healthcare costs and spending on medicines. 2014. http://www.imshealth.com/en/thought-leadership/ims-institute/reports/medicines-use-in-the-us-2014#medicines-use-and-spending-shifts-key-findings-panel4.
- 2.West L, Diack L, Cordina M, Stewart D. Applying the Delphi technique to define “medication wastage”. Eur J Hosp Pharm. 2015;22:274–9.CrossRefGoogle Scholar
- 3.Al-Shareef F, El-Asrar SA, Al-Bakr L, Al-Amro M, Alqahtani F, Aleanizy F, et al. Investigating the disposal of expired and unused medication in Riyadh, Saudi Arabia: a cross-sectional study. Int J Clin Pharm. 2016;38:822–8.CrossRefPubMedGoogle Scholar
- 4.Trueman P, Lowson K, Blighe A, Meszaros A, Wright D, Glanville J. Evaluation of the Scale, causes and costs of waste medicines. University of London: YHEC/School of Pharmacy; 2010.Google Scholar
- 5.Bach PB, Conti RM, Muller RJ, Schnorr GC, Saltz LB. Overspending driven by oversized single dose vials of cancer drug. Br Med J. 2016;. doi: 10.1136/bmj.i788.Google Scholar
- 6.Knoop B. [Increase expenses on expensive medicines]. 2016. https://www.medischcontact.nl/nieuws/laatste-nieuws/artikel/stijging-uitgaven-dure-medicijnen.htm [Dutch].
- 7.Braund R, Gn G, Matthews R. Investigating unused medications in New Zealand. Pharm World Sci. 2009;31:664–9.CrossRefPubMedGoogle Scholar
- 8.Ekedahl ABE. Reasons why medicines are returned to Swedish pharmacies unused. Pharm World Sci. 2006;28:352–8.CrossRefPubMedGoogle Scholar
- 9.Langley C, Marriott J, Mackridge A, Daniszewski R. An analysis of returned medicines in primary care. Pharm World Sci. 2005;27:296–9.CrossRefPubMedGoogle Scholar
- 10.Coma A, Modamio P, Lastra CF, Bouvy ML, Mariño EL. Returned medicines in community pharmacies of Barcelona, Spain. Pharm World Sci. 2008;30:272–7.CrossRefPubMedGoogle Scholar
- 11.Law AV, Sakharkar P, Zargarzadeh A, Tai BWB, Hess K, Hata M, et al. Taking stock of medication wastage: unused medications in US households. Res Soc Adm Pharm. 2015;11:571–8.CrossRefGoogle Scholar
- 12.Mackridge AJ, Marriott JF. Returned medicines: waste or a wasted opportunity? J Public Health (Bangkok). 2007;29:258–62.CrossRefGoogle Scholar
- 13.Chaiyakunapruk N, Thanarungroj A, Cheewasithirungrueng N, Srisupha-olarn W, Nimpitakpong P, Dilokthornsakul P, et al. Estimation of financial burden due to oversupply of medications for chronic diseases. Asia Pac J Public Health. 2012;24:487–94.CrossRefPubMedGoogle Scholar
- 14.Ostini R, Hegney D, Jackson C, Tett S. Knowing how to stop: ceasing prescribing when the medicine is no longer required. J Manag Care Pharm. 2012;18:68–72.PubMedGoogle Scholar
- 15.Ministry of Health W and S. [Report hotline Wastage in healthcare- I]. [Dutch]; 2013.Google Scholar
- 16.Lenzer J. US could recycle 10 million unused prescription drugs a year, report says. Br Med J. 2014;349:g7677.CrossRefGoogle Scholar
- 17.Tchen J, Vaillancourt R, Pouliot A. Wasted medications, wasted resource. Can Pharm J/Rev des Pharm du Canada. 2013;146:181–2.Google Scholar
- 18.Garey KW, Johle ML, Behrman K, Neuhauser MM. Economic consequences of unused medications in Houston, Texas. Ann Pharmacother. 2004;38:1165–8.CrossRefPubMedGoogle Scholar
- 19.Pomerantz J. Recycling expensive medication: why not? Medscape Gen Med. 2004;6:4.CrossRefGoogle Scholar
- 20.Al-Siyabi K, Al-Riyami K. Value and types of medicines returned by patients to sultan qaboos university hospital pharmacy, oman. Sultan Qaboos Univ Med J. 2007;7:109–15.PubMedPubMedCentralGoogle Scholar
- 21.Sequira D, Warner M. Stakeholder engagement : a good practice handbook for companies doing business in emerging markets. Washington: International Finance Corporation; 2007.Google Scholar
- 22.Pope C, Mays N. Reaching the parts other methods cannot reach: an introduction to qualitative methods in health and health services research. Br Med J. 1995;311:42–5.CrossRefGoogle Scholar
- 23.Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.CrossRefGoogle Scholar
- 24.MAXQDA, software for qualitative data analysis. Berlin: VERBI Software-Consult-Socialforschung GmbH. http://www.maxqda.com/.
- 25.Boeije H. Analysis in qualitative research, think and do. 2nd ed. Den Haag: Boom Lemma uitgevers [Dutch]; 2014.Google Scholar
- 26.Tong A, Sainsbury P, Craig J. Consolidated criterio for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus group. Int J Qual Health Care. 2007;19:349–57.CrossRefPubMedGoogle Scholar
- 27.Anderson C. Presenting and evaluating qualitative research. Am J Pharm Educ. 2010;74(8):141.CrossRefPubMedPubMedCentralGoogle Scholar
- 28.West LM, Diack L, Cordina M, Stewart D. A focus group based study of the perspectives of the Maltese population and healthcare professionals on medication wastage. Int J Clin Pharm. 2016;. doi: 10.1007/s11096-015-0233-x.Google Scholar
- 29.Mcrae D, Allman M, James D. The redistribution of medicines: could it become a reality? Int J Pharm Pract. 2016;. doi: 10.1111/ijpp.12275.PubMedGoogle Scholar
- 30.World Health Organization. Guidelines on packaging for pharmaceutical; 2002 (WHO technical report series, no. 902).Google Scholar
- 31.European Commission. Guidelines of 5 Novermber 2013 on good distribution practice of medicinal products for human use. Official Journal o the European Union; 2013. http://ec.europa.eu/health/files/eudralex/vol-1/2013_c343_01/2013_c343_01_en.pdf.